New Onset Seizure in the Elderly: Classification, Etiology, and Impact on Quality of Life and Caregiver Burden

Abstract

Objective The incidence of seizures is highest in the elderly, and their management is challenging in view of atypical presentation and comorbidities. The aims of this analysis were to study the classification, etiology, and risk factors in new onset seizures in the elderly (>60 years) and their impact on the quality of life (QOL) and caregiver burden.

Materials and Methods All the elderly presenting to neurology, neurosurgery and emergency medicine OPD with new onset seizures after the age of 60 years were included. QOL and caregiver burden were assessed at least 6 months after the first seizure. The QOL was assessed with the World Health Organization Quality of Life OLD (WHOQOL-OLD) and was compared with age-matched controls. Caregiver burden was assessed with the Zarit Burden Interview.

Result Eighty patients fulfilling the inclusion criteria and 80 age-matched controls were recruited. There was no difference in age (68.30 ± 6.22 vs. 69.09 ± 6.07 years; p = 0.39) and gender (M:F = 50:30 vs. 48:32; p = 0.74) among the cases and controls. Forty-four (55%) patients had focal seizure. Hypertension was the commonest risk factor (61.3%), followed by ethanol intake (40%) and diabetes (38.8%). Cerebrovascular disease was the commonest etiology (37.5%), followed by infection (15%). Thirteen (16.2%) patients died during hospital stay and 20 (25%) died after discharge from the hospital. Cases scored significantly low on all domains of WHOQOL-OLD at 6 months of follow-up. In all, 54.1% caregivers reported mild to moderate burden.

Conclusion Focal seizure is the commonest seizure type of new onset seizure in the elderly. Hypertension is the commonest risk factor and cerebrovascular disease is the commonest etiology. New onset seizures in the elderly have a significant impact on both QOL and caregiver burden.

Keywords

late onset seizures - new onset seizures in the elderly - quality of life - caregiver burden

Authors' Contribution

N.M. contributed to the design and conceptualization of the study, data collection and analysis, and drafting of the manuscript. N.C. contributed to acquisition of data and revision of the manuscript for intellectual content. P.S.K., S.V., A.A., and P.P. contributed to the design of the study and revision of the manuscript for intellectual content. J.B. contributed to the design and conceptualization of the study, data collection and analysis, and drafting and revision of the manuscript for intellectual content.

Note

This manuscript is neither published in part nor full. The abstract was presented at the 14th European Epilepsy Congress, Geneva, 2022.

Data Availability Statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Publikationsverlauf

Artikel online veröffentlicht:
01. Oktober 2024

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